Articulating Gender in the Context of ICTs in Health Care: The Case of Electronic Patient Records in the Maternity Services

Abstract

The article explores the articulation of gender in the context of information and communication technologies (ICTs) in health care. It explores how gender symbolism, gender structures and gender identities combine to produce what may be perceived as `resistance' to the development of electronic patient records (EPRs) in the maternity services. In particular, midwives define their work in opposition to computers, seeing IT work as antithetical to the core `woman-centred' philosophy of midwifery. The article argues that for ICTs to be used to improve both patient care and the skills and working lives of health care practitioners (as in New Labour's vision for the modern NHS), a far more detailed understanding of that care and those working lives is needed. The IT midwife is offered as a key figure in overcoming the gendered boundaries that exist between the IT and midwifery worlds. A case is made for this role to be expanded and supported to enable both sides to move beyond their traditional spheres to engage in the `co-production' of EPR systems that are acceptable to the maternity services staff and clients.

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“…As Doolin (2004) explains within information system architecture '[s]ome activities are given existence and attention while others remain unrecognized, enabling managerial knowledge to make stronger truth claims (Boland & Schultze 1996) and engendering compliance in those subject to such scrutiny' (p. 345). At least, in principle, as Doolin (2004) and others (Wilson 2002;Henwood & Hart 2003) have shown, professional resistance to using information systems may result in modified outcomes and disruption to managerial -professional power relations.…”

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“…Henwood and Hart, 56 for example, conducted a large, multisite case study of the introduction of electronic records in maternity units from the perspective of midwives. They found that in fewer than half of the units had midwives been consulted at all about the nature of their work or the design of the IT system.…”

“…So all this hi-tech stuff is just not what I think it's about. Senior midwife; p. 257 56 Having first positioned the ICT as 'masculine' and as interfering with the 'normal' process of birth, this interviewee went on to distance herself (and midwifery in general) from the low-status administrative work of 'data entry'. In her symbolic world, technology was either about ethereal, unreal aspects of care or not about care at all.…”